Surfactant protein C (SP-C), a lung-specific hydrophobic peptide that enhances the biophysical activity of surfactant phospholipid, is synthesized as a 21 kD propeptide (proSP-C21) and post-translationally processed to yield a 3.7 kD surface active alveolar form. The importance of SP-C to lung health and disease has been underscored by observations that heterozygous expression of mutations in the SP-C gene (SFTPC) in humans is associated with interstitial lung disease (ILD). Recent studies from our laboratory have: (i) identified a novel PPDY motif in the proSP-C NH2 terminus and its ligand the E3 ligase Nedd4-2 as crucial elements in the targeting of proSP-C to the distal secretory pathway; (ii) functionally characterized the consequences of improper folding of the proSP-C COOH terminus for epithelial cell dysfunction seen with aggregation prone SFTPC mutations (BRICHOS domain) found in patients with accompanying ILD; (iii) uncovered a second class of phenotypically distinct ILD-associated SFTPC mutations (Non-BRICHOS) that, while not ER retained, are instead mistrafficked to non-native organelles. Our published and new preliminary data also indicate that non-BRICHOS SP-C mutants disrupt both endosomal/ lysosomal function as well as macroautophagy producing cytotoxicity by ER stress independent pathways. This project seeks to build upon our long-standing discovery program studying cellular and molecular mechanisms underlying the biosynthetic metabolism of SP-C by further focusing on 3 emerging themes critical to lung cell biology: protein trafficking, organelle homeostasis, and cytoprotection. Specific Aim 1 will focus on defining the role of 4 key factors, the SP-C NH2 PPDY motif, Nedd4-2 WW domains, proSP-C monoubiquitination, and the adapter protein Golgi-associated, ?-adaptin homologues, Arf-binding protein 3 (GGA3) in anterograde trafficking of proSP-C. In addition, the consequences of proximal retention of proSP-C initiated by disruption of this targeting machinery will be studied using both well-characterized in vitro model systems and a new generation inducible, Cre-recombinase-driven mouse model of Nedd4-2 deficiency to evaluate quality control responses in vivo. In Specific Aim 2, mechanisms underlying AT2 cell dysfunction and cytotoxicity resulting from expression of mistrafficked non-BRICHOS SP-C mutant isoforms will be evaluated and compared with responses to aggregation prone COOH folding mutants. Results from the proposed studies will enhance our understanding of the molecular mechanisms underlying not only the pathophysiology of AT2 cell dysfunction that accompanies fibrotic lung remodeling in ILD but will provide a framework and model systems for personalized manipulation of proteostasis and cellular signaling for other disorders associated with parenchymal lung disease and epithelial dysfunction.